Purpose of the Program
The purpose of the diabetes management and quality improvement initiative is to act as a vehicle that is effective in enhancing the process of the healthcare provider and the outcome of patients. It will also decrease the proportion of complications related to diabetes. More than ninety-four percent of diabetic patients are expected to pay a visit to healthcare a provider during which there is the adequate handling of the diabetes issues. Such a scenario will indicate high levels of care usually necessary in the treatment of chronic conditions. Over the last four years, there has been an upsurge in the number of people suffering from diabetes. Increased enrollment of patients accounts for the increased diabetes incidence in the population to some extent (Boyle, 2013). However, a big part of the increase is a result of higher diabetes incidence among the populace. The age of diabetic patients has on average remained relatively constant. Most of the attributes relating to diabetes patients have experienced changes. The vital components of the diabetes quality improvement initiative are the enhancement process and patient outcome.
The target population for this project will be anyone aged three years or more and meet a given set of minimum conditions. One of the conditions is that such an individual should be a patient with an ED visit and a basic diabetes diagnosis (Boyle, 2013). The patient should have an inpatient visit with a diagnosis of diabetes that is primary. Such a patient needs to have also had at least two primary care contacts. In addition, the patients constituting the target population must have met HEDIS prescription requirement. It requires one to have received an insulin prescription with the right drug obtained from an agent in the list of diabetes drug distributors.
Benefits of the Program
Improvement of the kind of care that people who are suffering from diabetes access culminates into different benefits. Studies conducted at a national level point to several benefits to individuals. Health institutions have been able to cut down significantly on their costs. One of the advantages of the diabetes quality improvement initiative is a slowdown of the start of complications relating to diabetes and their progress (Bagnasco, 2014). Evidence from several UK-based studies supports this view. The most significant of these studies are UKPDS (UK Prospective Diabetes Study) and DCCT (Diabetes Control and Complications Trial).
The cost of handling diabetes can double or even triple if the quality of care accorded to diabetic patients is poor. The government and other economic entities spend colossal sums of money on the treatment of diabetes (Bagnasco, 2014). If the implementation of this program takes place, it is bound to result in a significant drop in the overall cost to the hospital. A reduction in the total cost of handling diabetic patients will enable the health facility to charge lower prices. A fall in the cost of treatment for patients coupled with improved care will attract more patients seeking treatment. The effect of this will be an increase in the number of patients able to access care and treatment for diabetes. The cost of implementing this project will also be progressively smaller as the necessary infrastructure will already be in place by the time patients start accessing the facilities availed by the program.
Basis of Evaluation
The basis of the evaluation of the project will be a number of performance measures. There will be a modification of the HEDIS criteria that the hospital will use in identifying patients with diabetes. A sample of patients selected at random will be defined for purposes of chart reviews. In trending the performance, the program will make use of a set of best practice guidelines. One of the standards will be the percentage of diabetes patients having two or more care visits within a time span of twelve months. The second one will be the percentage of the diabetic patients that have recorded a reading of their blood pressure in each of their continued care visits. Another practice to be used in trending is the proportion of diabetes patients having annual documentation of their foot exam. The fourth standard for use in developing a trend of the performance is the fraction of diabetes patients having an eye exam referral document annually (Bagnasco, 2014). The last measure is the section of diabetes patients having annual lipid panel results. The data obtained by the health facility for 2-3 years will be evaluated for the rates of hospital admissions, inpatient admission and, ED visits.
The design of the quality improvement initiative encompasses active collaborations between a number of different community agencies and some of the local networks. A combination of efforts and skills from various entities will help in achieving an optimal outcome that will be crucial to the success of the program (Obuchowski, 2005). The intervention targets persons considered high cost and high risk that stand to gain the most out of it. This paper seeks to show the viability of implementing a diabetes management and quality improvement initiative that will help in the prevention of long-term complications.